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Friday, March 7, 2014
I am a 33 year old female who started to experince extreme fatigue, joint pain, and mild fever of 99.5. At first went to my MD who performed an ANA which was 1:80. She sent me to a Rhematologist who diagnosed Fibromyalgia and als did a bunch of labs. Now my ANA is 1:160 homogenous pattern, but DNA antibodies, scleroderma antibodies, SM & RNP negative. My Hgb was 11.3 and HCT 34.3. WBC was 10.8 with absolute neutrophils of 7916. I still have joint pain, fever, dry eyes. Can you still have Lupus with all other test negative besides ANA positive?
It is very rare to have lupus in the absence of ANA. However, ANA can be present in low titers (1:80-1:160) in several situations, including after some infections and even in completely healthy people. Since your ANA did increase a little bit, a follow up exam by a rheumatologist and a repeat ANA test in 6 months or so might help to clinch a Dx.
If you have dry eyes, your rheumatologist may like to get an eye exam performed to look for Sjogren`s syndrome. Usually, Sx of dryness in eyes are accompanied by dryness in other mucosal sites such as the mouth or genital area. Eye exam, salivary gland Bx, and tests called anti-Ro or anti-La antibodies can help in this situation, if the diagnosis of Sjogren`s syndrome is strongly suspected. Before all these tests, of course one has to rule out the use of certain drugs or other problems that can cause dry eyes.
Ram Raj Singh, MD
Associate Professor of Clinical Medicine
College of Medicine
University of Cincinnati